<h1 class="page-title"><?php echo $this->translate("get keys"); ?></h1>
<div class="contact-form-container">
	<form method="post" action="">
    <div  class="form-title"><?php echo $this->translate("customer info"); ?></div>
	<ul class="form-fields">
		<li class="full-row">
			<label><?php echo $this->translate("name"); ?><em>*</em></label>
			<input class="input-text required-entry validate-email" name="name" type="text" />
            <?php if(isset($this->error['name'])): ?>

            <label class="required" for="name">

                <em><?php echo $this->error['name']; ?></em>

            </label>

            <?php endif; ?>
		</li>
		<li class="full-row">
			<label><?php echo $this->translate("email"); ?><em>*</em></label>
			<input class="input-text required-entry validate-email" name="email" type="text" />
            <?php if(isset($this->error['email'])): ?>

            <label class="required" for="email">

                <em><?php echo $this->error['email']; ?></em>

            </label>

            <?php endif; ?>
		</li>
	</ul>
	<div class="button-set">
		<p class="required">* <?php echo $this->translate("required"); ?></p>
		<button type="submit" class="form-button"><span><?php echo $this->translate("confirm"); ?></span></button>
	</div>
    </form>
</div>